K87 Hypertension complicated (ICD-10:I11)

Introduction

Hypertension, also known as high blood pressure, is a common condition that affects millions of people worldwide.^[1] When left untreated or poorly managed, hypertension can lead to complications and increase the risk of heart disease, stroke, and other serious health problems.^[2] This guide aims to provide healthcare professionals with a comprehensive overview of hypertension complicated, including its symptoms, causes, diagnostic steps, possible interventions, and patient education.

Codes

• ICPC-2 Code: K87 Hypertension complicated^[3]
• ICD-10 Code: I11 Hypertensive heart disease^[4]

Symptoms

• Headaches: Persistent or severe headaches, especially in the morning.^[5]
• Shortness of breath: Difficulty breathing or feeling breathless during physical activity or at rest.^[6]
• Chest pain: Discomfort or pain in the chest, often described as a tightness or pressure.^[7]
• Fatigue: Feeling tired or lacking energy, even after adequate rest.^[8]
• Vision problems: Blurred vision or changes in vision.^[9]
• Dizziness: Feeling lightheaded or faint.^[10]
• Nausea: Feeling sick or experiencing an upset stomach.
• Swelling: Edema or fluid retention, particularly in the legs, ankles, or feet.

Causes

• Primary hypertension: The exact cause is unknown, but it is believed to be influenced by a combination of genetic and environmental factors.
• Secondary hypertension: Caused by an underlying medical condition, such as kidney disease, hormonal disorders, or certain medications.

Diagnostic Steps

Medical History

• Gather information about the patient’s risk factors, including family history of hypertension, smoking, obesity, sedentary lifestyle, and high sodium or low potassium diet.
• Identify any existing medical conditions that may contribute to hypertension, such as diabetes, kidney disease, or hormonal disorders.
• Ask about symptoms related to hypertension, such as headaches, shortness of breath, chest pain, or vision problems.

Physical Examination

• Measure the patient’s blood pressure using a sphygmomanometer and stethoscope.
• Check for signs of organ damage, such as enlarged heart, abnormal heart sounds, or swelling in the legs.
• Assess the patient’s overall health, including weight, body mass index (BMI), and general appearance.

Laboratory Tests

• Complete blood count (CBC): To evaluate for anemia or other blood disorders.
• Basic metabolic panel (BMP): To assess kidney function, electrolyte levels, and blood glucose.
• Lipid profile: To measure cholesterol and triglyceride levels.
• Urinalysis: To check for protein or blood in the urine, which may indicate kidney damage.
• Thyroid function tests: To rule out thyroid disorders as a cause of hypertension.
• Renal function tests: To evaluate kidney function and identify any underlying kidney disease.

Diagnostic Imaging

• Echocardiogram: To assess the structure and function of the heart.
• Electrocardiogram (ECG): To evaluate the electrical activity of the heart.
• Chest X-ray: To check for signs of heart enlargement or fluid in the lungs.
• Doppler ultrasound: To assess blood flow in the arteries and veins.
• Computed tomography (CT) scan: To visualize the blood vessels and organs in the abdomen and pelvis.
• Magnetic resonance imaging (MRI): To obtain detailed images of the brain, heart, or other organs.

Other Tests

• Ambulatory blood pressure monitoring: To measure blood pressure at regular intervals over a 24-hour period.
• Exercise stress test: To evaluate the heart’s response to physical activity.
• Renal artery ultrasound: To assess blood flow in the renal arteries.
• Genetic testing: To identify any genetic mutations associated with hypertension.

Follow-up and Patient Education

• Schedule regular follow-up appointments to monitor blood pressure and assess the effectiveness of interventions.
• Educate the patient about the importance of lifestyle modifications, such as maintaining a healthy diet, engaging in regular physical activity, quitting smoking, and managing stress.
• Discuss the potential risks and benefits of medication therapy, including the importance of adherence to prescribed medications.
• Provide resources and support for the patient to make informed decisions about their healthcare.

Possible Interventions

Traditional Interventions

Medications:

Top 5 drugs for Hypertension complicated:

1. Angiotensin-converting enzyme (ACE) inhibitors (e.g., Lisinopril, Enalapril):
   • Cost: Generic versions can range from $10 to $50 per month.
   • Contraindications: History of angioedema, pregnancy, bilateral renal artery stenosis.
   • Side effects: Dry cough, dizziness, low blood pressure.
   • Severe side effects: Angioedema, hyperkalemia, renal failure.
   • Drug interactions: Nonsteroidal anti-inflammatory drugs (NSAIDs), potassium-sparing diuretics.
   • Warning: Regular monitoring of renal function and potassium levels is required.
2. Angiotensin receptor blockers (ARBs) (e.g., Losartan, Valsartan):
   • Cost: Generic versions can range from $10 to $50 per month.
   • Contraindications: Pregnancy, bilateral renal artery stenosis.
   • Side effects: Dizziness, low blood pressure, headache.
   • Severe side effects: Angioedema, hyperkalemia, renal failure.
   • Drug interactions: NSAIDs, potassium-sparing diuretics.
   • Warning: Regular monitoring of renal function and potassium levels is required.
3. Calcium channel blockers (e.g., Amlodipine, Nifedipine):
   • Cost: Generic versions can range from $10 to $50 per month.
   • Contraindications: Severe aortic stenosis, heart failure.
   • Side effects: Swelling in the ankles, flushing, headache.
   • Severe side effects: Low blood pressure, heart rhythm disturbances.
   • Drug interactions: Grapefruit juice, beta-blockers.
   • Warning: Regular monitoring of blood pressure and heart rate is required.
4. Diuretics (e.g., Hydrochlorothiazide, Furosemide):
   • Cost: Generic versions can range from $10 to $30 per month.
   • Contraindications: Severe renal impairment, anuria.
   • Side effects: Increased urination, low blood potassium levels.
   • Severe side effects: Electrolyte imbalances, dehydration.
   • Drug interactions: Nonsteroidal anti-inflammatory drugs (NSAIDs), lithium.
   • Warning: Regular monitoring of renal function and electrolyte levels is required.
5. Beta-blockers (e.g., Atenolol, Metoprolol):
   • Cost: Generic versions can range from $10 to $30 per month.
   • Contraindications: Severe bradycardia, heart block, asthma.
   • Side effects: Fatigue, dizziness, low blood pressure.
   • Severe side effects: Worsening of heart failure, bronchospasm.
   • Drug interactions: Calcium channel blockers, insulin.
   • Warning: Should not be abruptly stopped.

Alternative Drugs:

• Alpha-blockers (e.g., Doxazosin): May be used in combination with other antihypertensive medications.
• Direct renin inhibitors (e.g., Aliskiren): May be used as an alternative to ACE inhibitors or ARBs.
• Central alpha-2 agonists (e.g., Clonidine): May be used in resistant hypertension or as an adjunct therapy.

Surgical Procedures:

• Renal denervation: A minimally invasive procedure that disrupts the nerves in the kidneys to lower blood pressure. Cost: $15,000 to $30,000.
• Bariatric surgery: Weight loss surgery that can help improve blood pressure control in obese individuals. Cost: $20,000 to $35,000.
• Carotid endarterectomy: Surgical removal of plaque from the carotid arteries to reduce the risk of stroke. Cost: $15,000 to $30,000.
• Aortic aneurysm repair: Surgical repair of an enlarged aorta to prevent rupture. Cost: $30,000 to $50,000.
• Kidney transplant: For patients with end-stage renal disease and uncontrolled hypertension. Cost: $100,000 to $200,000.

Alternative Interventions

• Acupuncture: May help reduce blood pressure and improve overall well-being. Cost: $60 to $120 per session.
• Yoga and meditation: Can help reduce stress and promote relaxation. Cost: Varies depending on the class or instructor.
• Dietary supplements: Certain supplements, such as garlic, fish oil, and coenzyme Q10, may have potential benefits for blood pressure control. Cost: Varies depending on the specific supplement.
• Biofeedback: A technique that helps individuals learn to control their body’s response to stress. Cost: $50 to $100 per session.
• Mindfulness-based stress reduction: A program that combines mindfulness meditation, yoga, and group support to reduce stress. Cost: Varies depending on the program or instructor.

Lifestyle Interventions

• Dietary modifications: Encourage a diet rich in fruits, vegetables, whole grains, lean proteins, and low-fat dairy products. Limit sodium intake to less than 2,300 mg per day.
• Regular physical activity: Recommend at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise per week.
• Weight management: Advise overweight or obese individuals to lose weight through a combination of diet and exercise.
• Smoking cessation: Offer smoking cessation counseling and support to help patients quit smoking.
• Stress management: Teach stress reduction techniques, such as deep breathing exercises, meditation, or relaxation techniques.

It is important to note that the cost ranges provided are approximate and may vary depending on the location and availability of the interventions. Healthcare professionals should consider individual patient factors, preferences, and cost-effectiveness when determining the most appropriate interventions for hypertension complicated.

Mirari Cold Plasma Alternative Intervention

Understanding Mirari Cold Plasma

• Safe and Non-Invasive Treatment: Mirari Cold Plasma is a safe and non-invasive treatment option for various skin conditions. It does not require incisions, minimizing the risk of scarring, bleeding, or tissue damage.
• Efficient Extraction of Foreign Bodies: Mirari Cold Plasma facilitates the removal of foreign bodies from the skin by degrading and dissociating organic matter, allowing easier access and extraction.
• Pain Reduction and Comfort: Mirari Cold Plasma has a local analgesic effect, providing pain relief during the treatment, making it more comfortable for the patient.
• Reduced Risk of Infection: Mirari Cold Plasma has antimicrobial properties, effectively killing bacteria and reducing the risk of infection.
• Accelerated Healing and Minimal Scarring: Mirari Cold Plasma stimulates wound healing and tissue regeneration, reducing healing time and minimizing the formation of scars.

Mirari Cold Plasma Prescription

Video instructions for using Mirari Cold Plasma Device – K87 Hypertension complicated (ICD-10:I11)

Localized (0) Sacrum (1) Prostate & Uterus (2) Kidney, Liver & Spleen (3) Heart, Bile & Pancreas (4) Lungs (5) Throat, Lymphatic & Thyroid (6) Neuro system & ENT (7)

Use the Mirari Cold Plasma device to treat Hypertension complicated effectively.

WARNING: MIRARI COLD PLASMA IS DESIGNED FOR THE HUMAN BODY WITHOUT ANY ARTIFICIAL OR THIRD PARTY PRODUCTS. USE OF OTHER PRODUCTS IN COMBINATION WITH MIRARI COLD PLASMA MAY CAUSE UNPREDICTABLE EFFECTS, HARM OR INJURY. PLEASE CONSULT A MEDICAL PROFESSIONAL BEFORE COMBINING ANY OTHER PRODUCTS WITH USE OF MIRARI.

Step 1: Cleanse the Skin

• Start by cleaning the affected area of the skin with a gentle cleanser or mild soap and water. Gently pat the area dry with a clean towel.

Step 2: Prepare the Mirari Cold Plasma device

• Ensure that the Mirari Cold Plasma device is fully charged or has fresh batteries as per the manufacturer’s instructions. Make sure the device is clean and in good working condition.
• Switch on the Mirari device using the power button or by following the specific instructions provided with the device.
• Some Mirari devices may have adjustable settings for intensity or treatment duration. Follow the manufacturer’s instructions to select the appropriate settings based on your needs and the recommended guidelines.

Step 3: Apply the Device

• Place the Mirari device in direct contact with the affected area of the skin. Gently glide or hold the device over the skin surface, ensuring even coverage of the area experiencing.
• Slowly move the Mirari device in a circular motion or follow a specific pattern as indicated in the user manual. This helps ensure thorough treatment coverage.

Step 4: Monitor and Assess:

• Keep track of your progress and evaluate the effectiveness of the Mirari device in managing your Hypertension complicated. If you have any concerns or notice any adverse reactions, consult with your health care professional.

Note

This guide is for informational purposes only and should not replace the advice of a medical professional. Always consult with your healthcare provider or a qualified medical professional for personal advice, diagnosis, or treatment. Do not solely rely on the information presented here for decisions about your health. Use of this information is at your own risk. The authors of this guide, nor any associated entities or platforms, are not responsible for any potential adverse effects or outcomes based on the content.

Mirari Cold Plasma System Disclaimer

• Purpose: The Mirari Cold Plasma System is a Class 2 medical device designed for use by trained healthcare professionals. It is registered for use in Thailand and Vietnam. It is not intended for use outside of these locations.
• Informational Use: The content and information provided with the device are for educational and informational purposes only. They are not a substitute for professional medical advice or care.
• Variable Outcomes: While the device is approved for specific uses, individual outcomes can differ. We do not assert or guarantee specific medical outcomes.
• Consultation: Prior to utilizing the device or making decisions based on its content, it is essential to consult with a Certified Mirari Tele-Therapist and your medical healthcare provider regarding specific protocols.
• Liability: By using this device, users are acknowledging and accepting all potential risks. Neither the manufacturer nor the distributor will be held accountable for any adverse reactions, injuries, or damages stemming from its use.
• Geographical Availability: This device has received approval for designated purposes by the Thai and Vietnam FDA. As of now, outside of Thailand and Vietnam, the Mirari Cold Plasma System is not available for purchase or use.

References

1. World Health Organization. (2021). Hypertension. https://www.who.int/news-room/fact-sheets/detail/hypertension
2. Centers for Disease Control and Prevention. (2021). High Blood Pressure Symptoms and Causes. https://www.cdc.gov/bloodpressure/about.htm
3. World Organization of Family Doctors. (2016). ICPC-2: International Classification of Primary Care (2nd ed.). https://www.globalfamilydoctor.com/site/DefaultSite/filesystem/documents/Groups/WICC/International%20Classification%20of%20Primary%20Care%20Dec16.pdf
4. World Health Organization. (2019). ICD-11 for Mortality and Morbidity Statistics. https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1297190859
5. American Heart Association. (2017). What are the Symptoms of High Blood Pressure? https://www.heart.org/en/health-topics/high-blood-pressure/why-high-blood-pressure-is-a-silent-killer/what-are-the-symptoms-of-high-blood-pressure
6. Mayo Clinic. (2021). High blood pressure (hypertension) – Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410
7. American Heart Association. (2017). What are the Symptoms of High Blood Pressure? https://www.heart.org/en/health-topics/high-blood-pressure/why-high-blood-pressure-is-a-silent-killer/what-are-the-symptoms-of-high-blood-pressure
8. Campbell, Norm R.C. ; Lackland, Daniel T. ; Niebylski, Mark L. (2014.0). High Blood Pressure: Why Prevention and Control Are Urgent and Important—A 2014 Fact Sheet From the World Hypertension League and the International Society of Hypertension. DOI: 10.1111/jch.12372
9. GO, Alan S ; BAUMAN, Mary Ann ; COLEMAN KING, Sallyann M ; FONAROW, Gregg C ; LAWRENCE, Willie ; WILLIAMS, Kim A ; SANCHEZ, Eduardo (2014.0). An Effective Approach to High Blood Pressure Control: A Science Advisory From the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. DOI: 10.1016/j.jacc.2013.11.007
10. LI, C. J ; MIYAMOTO, Y ; KOJIMA, Y ; MAEDA, H (1993.0). Augmentation of tumour delivery of macromolecular drugs with reduced bone marrow delivery by elevating blood pressure. DOI: 10.1038/bjc.1993.179